The first objective of the study is to evaluate a treat to target treatment strategy in women with moderate to high disease activity of RA and a pregnancy wish, from pre-pregnancy. The treatment strategy is based on deliberate treatment decisions to lower disease activity, including the continuation or start of biological treatment (in particular anti-Tumor Necrosis Factor [anti-TNF]), based on a standard care protocol in the Erasmus MC. The second objective is to evaluate the safety of the use of anti-TNF during pregnancy among women with a rheumatic disease that require the use of anti-TNF before or during pregnancy.

DAS28(3)CRP at all study points [ Time Frame: Every 3 months from baseline till 6 months after delivery ]

Secondary Outcome Measures:

Time to pregnancy [ Time Frame: At baseline and every 3 months till pregnant ]

Patient is asked whether is she is pregnant. Pregnancy is defined as positive pregnancy test or ultrasound.

Number of miscarriages [ Time Frame: After conception, every 3 months ]

Patients normally report miscarriages spontaneously at the next visit after miscarriage or contact the research nurse themselves to report this. If not, and patient is not pregnant anymore, reason for ending of pregnancy will be asked.

Complications during pregnancy [ Time Frame: Every 3 months during pregnancy and first visit after delivery ]

For first objective: Women with high disease activity of RA and a pregnancy wish.

For second objective: Women with a rheumatic disease that requires the use of anti-TNF before or during pregnancy

Criteria

Inclusion criteria for first objective (150 subjects)

Rheumatoid Arthritis according to 2010 ACR/EULAR criteria

active pregnancy wish

either DAS28(3)CRP > 3.2 or the current use of anti-TNF

Inclusion criteria for second objective (no limit on number of subjects needed, recruitment will end when 150 RA patients have been included)

rheumatic disease that requires the use of anti-TNF before or during pregnancy

active pregnancy wish

Exclusion criteria:

- none

Contacts and Locations

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study.
To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below.
For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01345071